Croatia debates conscientious objection for pharmacists
by Michael Cook | 1 Dec 2018 |
Rows over conscientious objection (CO) in medicine are not unique to the English-speaking world. This example comes from Croatia, where a pharmacist invoked CO and refused to supply contraceptive tablets to a customer. She asked the woman to return the following day when a more cooperative colleague would be on duty.
The customer complained and the case was referred to the The Croatian Chamber of Pharmacists' (CPP) ethics commission. This week the CPP ruled that the pharmacist had not violated its code of ethics. It declared that according to the code, pharmacists have a right to CO as long as they do not endanger a patient's health and life.
The commission, however, used the case to remind pharmacists of the importance of organising work so that all patients can be catered for.
The case has divided public opinion in the Balkan nation. The president of the CPP, Ana Soldo, told the media said that the rights of one group cannot be prioritised over the rights of another. Doctors have a right to conscientious objection in the same way, she said, that women have the right to decide what happens to their bodies.
Health Minister Milan Kujundžić disagreed. A pharmacist “has the right to conscientious objection but not in their workplace,” he said.
The gender equality ombudsperson, Višnja Ljubičić, contended out that the right to conscientious objection is individual. Pharmacies must ensure that all patients can be serviced. In her opinion, refusal was a clear violation of the code of ethics: “In this particular case, if a pharmacy as an institution as a whole is unable to issue a medicine due to the conscientious objection of its employees, I consider this to be a threat to the user’s health.”
The debate has been fuelled by similar disputes over provision of abortion, which is legal in Croatia.
Sunday, December 2, 2018
Many scientists were aghast this week when a Chinese expert in CRISPR, He Jiankui, announced the birth of gene-edited twins – probably the world’s first “designer babies”.
Dr He is being described as a “rogue scientist” who ignored the rules. But that is the way that whole field of reproductive technology has advanced. Bob Edwards, who won the Nobel Prize in Medicine for developing IVF, never sought ethics approvals or worried about the safety of the children.
In fact, he was an unashamed eugenicist. As Edwards said in 1999: “Soon it will be a sin for parents to have a child that carries the heavy burden of genetic disease. We are entering a world where we have to consider the quality of our children.” Edwards did not even seem to worry about the higher rate of birth defects among IVF children. They were just collateral damage of the “clinical imperative”.
Yet now Bob Edwards is regarded as a hero -- because his risky experiment worked.
I think that it is a bit unfair to label Dr He as a rogue. In fact, his robe-tearing, scandalised colleagues agree that editing the human genome is ethical. They are just worried that he did not tick all the boxes and do all the paperwork. This is very bad public relations for them and for the Chinese government.
In fact, given the deteriorating place of human rights in China at the moment, He Jiankui will be lucky to escape a long prison term -- or even execution – to regild the government’s tarnished image as a watchdog of uber-ethical science.
Dr He is being described as a “rogue scientist” who ignored the rules. But that is the way that whole field of reproductive technology has advanced. Bob Edwards, who won the Nobel Prize in Medicine for developing IVF, never sought ethics approvals or worried about the safety of the children.
In fact, he was an unashamed eugenicist. As Edwards said in 1999: “Soon it will be a sin for parents to have a child that carries the heavy burden of genetic disease. We are entering a world where we have to consider the quality of our children.” Edwards did not even seem to worry about the higher rate of birth defects among IVF children. They were just collateral damage of the “clinical imperative”.
Yet now Bob Edwards is regarded as a hero -- because his risky experiment worked.
I think that it is a bit unfair to label Dr He as a rogue. In fact, his robe-tearing, scandalised colleagues agree that editing the human genome is ethical. They are just worried that he did not tick all the boxes and do all the paperwork. This is very bad public relations for them and for the Chinese government.
In fact, given the deteriorating place of human rights in China at the moment, He Jiankui will be lucky to escape a long prison term -- or even execution – to regild the government’s tarnished image as a watchdog of uber-ethical science.
Michael Cook Editor BioEdge |
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